WEISER PHARMA

Reporting to the Blue Card Scheme

Thank you for choosing to report a suspected adverse reaction to the Blue Card Scheme. The information that you provide can help us in our work to identify previously unrecognised side effects, and thereby improve the safe use of medicines. To be able to submit a report, we need you to provide basic information about:

- The suspected reaction(s)
- The drug(s) you suspect caused the reaction(s)
- Details of the patient
- Your contact details as the reporter of the reaction

if you are able to provide any extra information (i.e. dates of the suspected reactions, any relevant patient history, other medications being taken at the time of the reaction), then this can be added in the final section of the report the 'additional details' screen.
Please download, print and fill the"Blue Card Form" pdf file

Email to info@weiserpharma.com

Or fax to: +(202) 46652387
Thank you for your time